牵扳法联合中药塌渍治疗血瘀型腰椎间盘突出症的疗效观察

发布时间：2018-02-26 08:12

本文关键词： 腰椎间盘突出症血瘀证牵扳法中药塌渍疗效观察　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：腰椎间盘突出症表现为腰痛及下肢坐骨神经放射痛,是在腰椎间盘退变的基础上,加之外力的作用,导致髓核突出,压迫脊髓及神经根等引起的。在保守治疗中,牵扳法联合中药塌渍治疗腰椎间盘突出症不失为一种良好的选择。牵扳法就是牵引与扳法的合称。牵引可以使椎体间隙变宽,牵拉后纵韧带,减少椎间盘压力,从而促使髓核不同程度的回纳。同时牵引还可以纠正脊柱的生理曲度及侧弯畸形,增强腰椎的稳定性。而扳法可以调整小关节的紊乱,缓解肌肉的痉挛,促进局部血液循环,并使部分髓核发生位移,改变神经根和突出物的位置关系,分离神经根的粘连,缓解神经根受压或受刺激,使症状缓解甚至消失[1]。所以牵扳法对腰椎间盘突出症的治疗效果是肯定的。而中药塌渍治疗可以促进局部血液循环,达到活血化瘀,行气止痛的功效。另外,牵扳法和中药塌渍属于中医独特的治疗手段。二法操作简便,易于掌握。在临床治疗上二法还具有疗程短、见效快、易接受、病人痛苦少、医疗费用低、无副作用的特点。目的:通过观察两种治疗方案(牵扳法联合中药塌渍、单一牵扳法)治疗血瘀型腰椎间盘突出症的临床疗效,为临床治疗腰椎间盘突出症提供规范化的治疗方案,同时为今后进一步临床研究提供参考,最大程度地发挥保守治疗本病的优势。方法:选择2015年3月至2016年1月在长春中医药大学附属医院骨科住院的血瘀型腰椎间盘突出症患者60例,将其随机分为治疗组和对照组,疗程均为14天。治疗组采用牵扳法联合中药塌渍治疗;对照组采用单一牵扳法治疗;将两组患者治疗前后进行量化评分,通过研究比较60例患者治疗前后的评价指标,最终得出科学的临床数据。结果:实际统计病例60例。两组方案均能有效治疗血瘀型腰椎间盘突出症,但在治疗14天后,治疗组总有效率为93.3%;对照组总有效率为83.3%,治疗组与对照组存在显著差异。结论:经过观察,两组方案治疗腰椎间盘突出症都能取得很好的疗效,对于血瘀证腰椎间盘突出症患者,牵扳法联合中药塌渍的治疗组疗效优于单一牵扳法的对照组。这说明中医综合治疗为治疗本病的发展趋势,各种方法协同作用,优势互补,才能够疗效显著。而且此治疗方案简单、价廉、安全性高,是一种合理有效的治疗方案,值得临床推广。
[Abstract]:Lumbar disc herniation is characterized by low back pain and radialgia of the sciatic nerve of the lower extremity. It is based on the degeneration of the lumbar intervertebral disc, combined with the effect of external force, resulting in nucleus pulposus protrusion, compression of the spinal cord and nerve root, etc. In conservative treatment, It is a good choice to treat lumbar intervertebral disc herniation with traditional Chinese medicine. Traction is the combination of traction and traction. Traction can widen the intervertebral space, pull the posterior longitudinal ligament, and reduce the pressure of the intervertebral disc. At the same time, traction can also correct the physiological curvature and lateral curvature of the spine and enhance the stability of the lumbar vertebrae. And the pull method can adjust the disorder of the facet joints, relieve the spasm of the muscles, and promote the local blood circulation. Some of the nucleus pulposus were displaced, the relationship between nerve root and protruding was changed, the adhesion of nerve root was separated, and the compression or stimulation of nerve root was alleviated. The symptoms were alleviated or even disappeared [1] .Therefore, the therapeutic effect of pulling and pulling method on lumbar disc herniation was positive. The traditional Chinese medicine can promote local blood circulation, promote blood circulation, remove blood stasis, and relieve qi and pain. In addition, The two methods are simple and easy to master. In clinical treatment, the two methods also have short course of treatment, quick effect, easy acceptance, less pain for patients, and low medical cost. Objective: to observe the clinical effect of two kinds of treatment schemes on blood stasis type lumbar intervertebral disc herniation. To provide a standardized treatment plan for clinical treatment of lumbar disc herniation, and to provide a reference for further clinical research in the future. Methods: from March 2015 to January 2016, 60 patients with blood stasis type lumbar disc herniation in orthopaedics department of Changchun University of traditional Chinese Medicine were randomly divided into treatment group and control group. The course of treatment was 14 days. The treatment group was treated with pulling method combined with Chinese medicine collapse; the control group was treated with single pulling method; the two groups were scored quantitatively before and after treatment, and the evaluation indexes of 60 patients before and after treatment were compared. Finally, scientific clinical data were obtained. Results: 60 cases were counted. Both groups were effective in the treatment of blood stasis type lumbar disc herniation, but after 14 days of treatment, The total effective rate of the treatment group was 93.3g and the total effective rate of the control group was 83.3. There was a significant difference between the treatment group and the control group. Conclusion: after observation, both groups can achieve good results in the treatment of lumbar disc herniation. For the patients with lumbar intervertebral disc herniation of blood stasis syndrome, the curative effect of the treatment group combined with traditional Chinese medicine is better than that of the control group with single pulling method. This shows that the comprehensive treatment of traditional Chinese medicine is the development trend of the treatment of this disease, and all kinds of methods have synergistic effects and complementary advantages. It is simple, cheap and safe. It is a reasonable and effective treatment and is worth popularizing in clinic.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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